(a) Field of the Invention
This invention relates to a mediastinoscope having a shaft which is traversed by a photoconductor and an observation optical system.
(b) Description of the Prior Art
Mediastinoscopes are known which have a shaft traversed by an observation optical system.
The principle of the surgical treatment of aesophageal carcinoma consists in the extensive surgical removal of the aesophagus and the replacement of the organ by a hoisted part of the stomach or interpolation of an intestine part.
An exact removal of the aesophagus can be effected only by a simultaneous opening of the pleural cavity and of the abdominal cavity. However, this leads to an extreme burdening of the patient and to an increased risk. Frequently, therefore, nowadays the removal of the aesophagus by way of an opening of the pleural cavity is dispensed with and instead an obtuse dissection is undertaken.
For this purpose, on the left-hand side of the neck above the clavicle an incision is undertaken and through this the aesophagus is severed surgically both at its cervical end and, after opening of the abdominal cavity has been effected, in the region of the cardia. Then, through the opened abdomen and the detached aesophagus a probe or respectively an auxiliary instrument is conducted as far as the upper detached partially free-dissected and inwardly turned-over end and is connected to this. Simultaneously with the free-dissecting of the aesophagus in the direction of the abdomen by means of a finger the aesophagus is drawn into the abdominal cavity. Since, the case of this mode of procedure, the aesophagus cannot be completely detached from the surrounding mediastinum, it is necessary to tear the residual length off.
After removal of the aesophagus from the opened abdomen has been effected, this can be replaced by an interponate. This type of removal of aesophaguses is bound up with considerable risk for the patient, since inter alia haemorrhages occurring upon the blind free-dissection of the aesophagus cannot be immediately discerned and coagulated.
The main object of the present invention consists in being able to perform free-dissection of the aesophagus from the surrounding tissue under direct observation, being able to stanch at once possible occurring haemorrhages and being able to remove accumulations of body secretions such as blood and the like in a deliberate manner.